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Purpose: The purpose of this study was to assess the effect of training with a personal, portable laparoscopic endo-trainer (PLET) on residents' laparoscopic skills., Methods: The study took place at a tertiary-care academic university hospital in Switzerland. All participants were randomized to either a home- or hospital-based PLET training group, and surgical skill performance was assessed using five laparoscopic exercises. 24 surgical residents, 13 females and 11 males, were enrolled at any training stage. Nine residents completed the assessments. Endpoints consisted of subjective and objective assessment ratings as well as exercise time and qualitative data up to 12 weeks. The primary outcome was the difference in exercise time and secondary outcomes included performance scores as well as qualitative data., Results: The hospital-based training group performed exercises number 1, 3 and 4 faster at 12 weeks than at baseline (p = .003, < 0.001 and 0.024). Surgical skill performance was not statistically significantly different in any of the endpoints between the hospital- and home-based training groups at 12 weeks. Both the subjective and objective assessment ratings significantly improved in the hospital-based training group between baseline and 12 weeks (p = .006 and 0.003, respectively). There was no statistically significant improvement in exercise time as well as subjective and objective assessment ratings over time in the home-based training group. The qualitative data suggested that participants who were randomized to the hospital-based training group wished to have the PLET at home and vice versa. Several participants across groups lacked motivation because of their workload or time constraints, though most believed the COVID-19 pandemic had no influence on their motivation or the time they had for training., Conclusion: The PLET enhances laparoscopic surgical skills over time in a hospital-based training setting. In order to understand and optimize motivational factors, further research is needed., Trial Registration: This trial was retrospectively registered on clinicaltrials.gov (NCT06301230)., (© 2024. The Author(s).)

Purpose: Due to improved survival of esophageal cancer patients, long-term quality of life (QoL) is increasingly gaining importance. The aim of this study is to compare QoL outcomes between open Ivor Lewis esophagectomy (Open-E) and a hybrid approach including laparotomy and a robot-assisted thoracic phase (hRob-E). Additionally, a standard group of healthy individuals serves as reference., Methods: With a median follow-up of 36 months after hRob-E (n = 28) and 40 months after Open-E (n = 43), patients' QoL was assessed using the European Organization for Research and Treatment of Cancer (EORTC) QoL Questionnaire Core 30 (QLQ-C30) and the EORTC Esophagus specific QoL questionnaire 18 (QLQ-OES18)., Results: Patients showed similar clinical-pathological characteristics, but hRob-E patients had significantly higher ASA scores at surgery (p < 0.001). Patients and healthy controls reported similar global health status and emotional and cognitive functions. However, physical functioning of Open-E patients was significantly reduced compared to healthy controls (p = 0.019). Operated patients reported reduced role and social functioning, fatigue, nausea and vomiting, dyspnea, and diarrhea. A trend towards a better pain score after hRob-E compared to Open-E emerged (p = 0.063). Regarding QLQ-OES18, hRob-E- and Open-E-treated patients similarly reported eating problems, reflux, and troubles swallowing saliva., Conclusions: The global health status is not impaired after esophagectomy. Despite higher ASA scores, QoL of hRob-E patients is similar to that of patients operated with Open-E. Moreover, patients after hRob-E appear to have a better score regarding physical functioning and a better pain profile than patients after Open-E, indicating a benefit of minimally invasive surgery., (© 2024. The Author(s).)

Hypothesis: Previously, we examined the impact of two preparation procedures on the mechanical properties of native gelatin gels. In this work, we extend our research by considering hard spherical particles as fillers. We expect that the presence of these fillers significantly affects the viscoelastic response., Experiments: We prepared fresh in situ gels and individual gel layers filled with glass micro-beads up to 1% w/w and aged for 24 and 48 h. The hydrogels were made of 3 and 5% w/w gelatin at 5 °C, and we performed large amplitude oscillatory shear (LAOS) tests. We analyzed the intracycle linear and nonlinear response using normalized Lissajous-Bowditch curves. Utilizing the MITlaos software, we decomposed the total intracycle stress into elastic and viscous contributions and calculated the Chebyshev harmonics coefficients., Findings: The fresh in situ gels exhibit severe progressive stiffening during the strain sweeps and a subsequent sharp decrease of both moduli. The filled layers show smoother yielding than the in situ gels. The fillers increase the dynamic moduli, affect the terminal LAOS regime, and enhance the intracycle nonlinearities at higher concentrations. The Lissajous-Bowditch curves of the aged layers indicate elastoplastic behavior, which is more pronounced for the 48 h filled gel layer than the native counterpart., (Copyright © 2019 Elsevier Inc. All rights reserved.)

The gelation procedure and the gelation time of gelatin gels may lead to apparently similar materials, however, with different rheological fingerprints under small and large oscillatory shear deformations. Here, in the first paper of this series, gelation of 3 and 5% w/w gelatin solutions at 5 °C was performed in situ on the rheometer plate and in custom-made casting modules to obtain individual gel layers. Large amplitude oscillatory shear (LAOS) tests were performed. The nonlinear deformation regime was qualitatively analyzed using normalized Lissajous-Bowditch curves. The MITlaos software was employed to decompose the total intracycle stress response and to calculate the Chebyshev coefficients ratios. The dynamic moduli of the fresh gels were measured directly after the in situ preparation and within a time frame until 1.5 h. In the strain sweeps, we observed intense stiffening followed by yielding above 200% strain. However, the individual gel layers aged for 24 and 48 h show different LAOS fingerprints. The extensive loops in the viscous Lissajous-Bowditch curves indicate an elastoplastic material response. Based on the overall nonlinear rheological response, we propose a structural formation that describes the behavior of the gels for the conditions studied here. In the second paper of this series, we give the impact of hard micro-fillers (glass beads) and we describe the nonlinear characteristics of the filled gels., (Copyright © 2019 Elsevier Inc. All rights reserved.)

It is essential for microbes to acquire information about their environment. Fungi use soluble degradation products of plant cell wall components to understand the substrate composition they grow on. Individual perception pathways have been well described. However, the interconnections between pathways remain poorly understood. In the present work, we provide evidence of crosstalk between the perception pathways for cellulose and the hemicellulose mannan being conserved in several filamentous fungi and leading to the inhibition of cellulase expression. We used the functional genomics tools available for Neurospora crassa to investigate this overlap at the molecular level. Crosstalk and competitive inhibition could be identified both during uptake by cellodextrin transporters and intracellularly. Importantly, the overlap is independent of CRE-1-mediated catabolite repression. These results provide novel insights into the regulatory networks of lignocellulolytic fungi and will contribute to the rational optimization of fungal enzyme production for efficient plant biomass depolymerization and utilization. IMPORTANCE In fungi, the production of enzymes for polysaccharide degradation is controlled by complex signaling networks. Previously, these networks were studied in response to simple sugars or single polysaccharides. Here, we tackled for the first time the molecular interplay between two seemingly unrelated perception pathways: those for cellulose and the hemicellulose (gluco)mannan. We identified a so far unknown competitive inhibition between the respective degradation products acting as signaling molecules. Competition was detected both at the level of the uptake and intracellularly, upstream of the main transcriptional regulator CLR-2. Our findings provide novel insights into the molecular communication between perception pathways. Also, they present possible targets for the improvement of industrial strains for higher cellulase production through the engineering of mannan insensitivity., (Copyright © 2019 Hassan et al.)

We study shear banding in a planar 4:1 contraction flow using our recently developed two-fluid model for semidilute entangled polymer solutions derived from the generalized bracket approach of nonequilibrium thermodynamics. In our model, the differential velocity between the constituents of the solution allows for coupling between the viscoelastic stress and the polymer concentration. Stress-induced migration is assumed to be the triggering mechanism of shear banding. To solve the benchmark problem, we used the OpenFOAM software package with the viscoelastic solver RheoTool v.2.0. The convection terms are discretized using the high-resolution scheme CUBISTA, and the governing equations are solved using the SIMPLEC algorithm. To enter into the shear banding regime, the uniform velocity at the inlet was gradually increased. The velocity increases after the contraction due to the mass conservation; therefore, shear banding is first observed at the downstream. While the velocity profile in the upstream channel is still parabolic, the corresponding profile changes to plug-like after the contraction. In agreement with experimental data, we found that shear banding competes with flow recirculation. Finally, the profile of the polymer concentration shows a peak in the shear banding regime, which is closer to the center of the channel for larger inlet velocities. Nevertheless, the increase in the polymer concentration in the region of flow recirculation was significantly larger for the inlet velocities studied in this work. With our two-fluid finite-volume solver, localized shear bands in industrial applications can be simulated.